Thyroid Hormones (FT4, FT3): What's Optimal?
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- čas přidán 25. 05. 2024
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Papers referenced in the video:
The Aging Thyroid: A Reappraisal Within the Geroscience Integrated Perspective pubmed.ncbi.nlm.nih.gov/31074...
Thyroid hormones and frailty in persons experiencing extreme longevity pubmed.ncbi.nlm.nih.gov/32525...
FT3/FT4 ratio is correlated with all-cause mortality, cardiovascular mortality, and cardiovascular disease risk: NHANES 2007-2012
pubmed.ncbi.nlm.nih.gov/36060...
Relationship of gender and age on thyroid hormone parameters in a large Chinese population pubmed.ncbi.nlm.nih.gov/31576...
Heterogeneity of Thyroid Function and Impact of Peripheral Thyroxine Deiodination in Centenarians and Semi-Supercentenarians: Association With Functional Status and Mortality pubmed.ncbi.nlm.nih.gov/30165...
Association of sensitivity to thyroid hormones with all-cause mortality in euthyroid US adults: a nationwide cohort study. www.ncbi.nlm.nih.gov/pmc/arti... - Věda a technologie
very interesting, as always. The thyroid system appears to me as one of the most complex in the body. While the textbook descriptions are kind of simplified, I think there is a whole bunch of regulations not yet described.
For instance, immune system and energy producing system are cross linked in multiple ways, hence i would expect that certain activities in the immune system also affect the thyroid system.... what do you think?
About Selenium: there is also a lot in sardines, according to cronometer, which is my main source of it
.( the units for the T3 conversion are likely be the other way round)
Only 40 mcg of selenium per 180 calorie for the sardines that I eat, which isn't much...
I have measured my TSH/FT3/FT4/rT3 several times in past few years .. Also Se, Zn, Fe, I etc. All in good shape.
1) T4---> T3 conversion requires Carbs or else Adrenal activation blocks/reduces conversion for protection. Most Keto/Carnivores have low fT3 for this reason.
2) Veggies have in general higher fT3. Fruits+ Vegs keeps thyroid happy
3) CR will reduce fT3 ( increase in rT3) as body goes in starvation mode- Anything that makes body think scarcity of food will dial down fT3.
4) Stress shoots rT3 to deal with stress and lower fT3.
5) Besides iodine, good Se, Zn and Fe panel needed for thyroid to function smoothly and conversion.
6) Anything that activates adrenal ( epinephrine, cortisol, etc.) will dial down fT3 for protection - HPA and HPT axis work in coordination besides HPG axis ( Hypothalamus - Pituitary- Adrenal or Thyroid or Gonad)
Sum total- Most happy people who eat lots of veggies ( fruits + Veggies) have good thyroid besides heart/brain.
Really interesting video - and thanks for shedding some light into the thyroid hormone system.
Seeing the importance of this fT3/fT4 ratio, I wonder even more why doctors typically only prescribe levothyroxin, which is equivalent to fT4. This means your body needs to convert quite a lot of fT4. There are alternatives which give the body also some fT3, and are better tolerated by some people (e.g., natural Desiccated thyroid from cows or pigs)
In any case, curious to see how Selenium will influence this.
I think you are aware that Brazil nuts have a relatively high natural radiation within them (for kids and during pregnancy not recommended) - I would assume even in your dose you should be ok
very good thanks
Love the short often vids
Often videos but short (this one was relatively long)? The next will be ~2 minutes
CR almost certainly is contributing to the April 2024 test. There's pretty extensive literature on weight loss subjects that shows the ratio reduces. Most of those studies are around a ~10% reduction, which wouldn't explain a 40% decrease in your case.
To test that, calories are purposefully higher for the next test (aiming for Tuesday) for the 1st time in 3y.
But, Brazil nuts are also increased, so it will be tough to say if it's selenium or calories, for now (assuming it's higher for the next test, which it might not be).
I forgot to say I also took lugol from 2015 to last week when I decided to go off iodine to see how it reacts. While It may sound counterintuitive, it's a reasonable course of action to lower your anti TPO's, which in my case went from 28 to 41 in just 4 months.
Excellent review. I am an active middle age guy. My ft3/ft4 got as low as 0.19 (active mid 40's) before I started liothyronine. PCP and I first tried levothyroxine with no effect on FT3 and a worsening of RT3. Now slowly titrating FT3. Working on getting it more optimized. Interested to see what you dig up on Uric Acid something else I am working on optimizing.
I really appreciate your work and I'd like to say we're in the same boat. I started doing the same last semester
I've been eating Brazil nuts for the past 22 years now, always 3 to 4 nuts a day until 2 years ago when I cut it down to just 1. I strongly suggest you buy them shelled and keep them in the freezer and at least 8 hours before consuming them, crack 2 or 3 open, put them into a glass of water and squeeze a few drops of ACV, lemon or lime to kill any possibly existing fungus as well as to draw phytic acid, which is a nutrient robber. Wash them off with filtered water right before eating them and with them take 15mg of chelated zinc.
Nice, thanks @rodrigsantsil
@@conqueragingordietrying1797 You're welcome!
Should the ratio be between pmol to pmol?
Btw, I'm hypothyroid too, dose 107mcg per day. Ft3 will increase with caloric intake. Weight loss crushes ft3. Mine fell from 3.5 pg/ml to 2.8 during weight loss. This might recover when I start eating more to maintain.
It is clear why T3 falls during weight loss. Metabolism slows down to fight the weight loss. T3 is directly responsible for the metabolic adaptation in BMR and NEAT reduction seen during weight loss. T3 also falls much more on a low carb/keto diet when the body thinks it's starving even compared to isocaloric but higher carb diet.
Finally, T3 is also low for ICU patients going to die soon. It's a marker of poor health. It's called non thyroidal illness syndrome.
As long as the units match, whether pmol to pmol, pg/mL, or ng/dL
Interesting about calorie intake-I've recently increased it by a small amount, we'll see if it impacts FT3 in my case
Great video (as usual) What do you think about supplementing with Tyrosine ?
Thanks @startingtoday4663. While I see the rationale for making more T4 with tyrosine, that might not fix the age-related conversion issue...
Gotta love ya, Mike. You've been down in the science data shaft now for nine years wearing your miner's hat--with your coal spade and a canary sifting through the detritus for longevity gems to share with your herd.
I wonder how tedious your method gets for you when it comes to weighing all your food and subjecting yourself to strict eating windows and boxing contender weight-lifting regimens. What do you do for fun? Teaching your paid clients your longevity method must be a tough sell if they try to do what you do. As a Health Coach, I find it hard to get people to make any kind of profound change to their diets. And ask them to incorporate exercise? It's why I haven't started charging yet. Getting people to make healthy changes only works for those who are all in and seriously want to improve.
As a fellow home vegetable grower, I would like to recommend two super nutritious veggies I reluctantly tried to see if they'd flourish indoors. I bought 4 ounces of radicchio and Chinese celery seeds from True Leaf, and wow, these two nutrient-dense beauties have taken off in a big way. You should check out the Chinese celery and radicchio nutrition profile.
You told me that you do not have longevity in your DNA. But just doing what you are doing should give you added healthy years, I'd think.
On a different note, though, I'd like to share with you one of my favorite quips from Bernardo Kastrup: "The more transcendent you become, the less you will care about surviving." As a fellow philosopher, you may have come across his work.
I will share with you a recent video that I find riveting. It deals with the science of consciousness and the theory that there is a much deeper meaning to life-or what we currently perceive 'life' to be.
This interview video discusses thoughts and theories from Bernardo Kastrup and Christof Koch. These may be two of the smartest dudes on the planet. I guess I should warn you that the subject matter involves both of them speaking about their journeys under the influence of psychedelics. I am trying to find a reliable source for experimenting with psychedelics but have found only street trash from questionable characters. A website I have found, Psychedelic Passage, could be the pathway.
Bernardo Kastrup VS Christof Koch ://czcams.com/video/qzwC7sXyhWQ/video.htmlsi=_9BZPdutUsHQD9e
This video-should you choose to watch it-is 1:40 long and gets more interesting as it goes on. It's better if you watch it in one sitting, but it's not necessary.
At this point, I think living long enough to become transcendent is all we can hope for. We learn and grow so much every year of our lives.
Spoiler alert! Bernardo and Christof say this place we inhabit now is NOT reality. This idea, coming from these two brilliant men, is a chilling one to ponder.
This life may just be step one of a much deeper and interesting plain of existence.
Please watch the video when you have time.
Thanks
It's not tedious at all for me, Paul, and great comments!
For me, creating is fun, but I'm also a big sports fan (MMA, basketball, baseball, American football).
I agree about the difficulty for most people changing their habits, but those that I work with are a highly motivated bunch.
Yep, we can perceive only a small portion of reality (Donald Hoffman is another in that space)-In terms of the linked video, I'm thinking about asking Stuart Hameroff to be a guest on the channel-his work on consciousness is at the intersection of biology with quantum physics.
@@conqueragingordietrying1797 That I would welcome. And much more along those lines. Do you watch Closer To Truth? There are some terrific interviews there.
Hello Dr. Lustgarten. May I suggest that you make a video on body temperature as an ageing/longevity biomarker and how to lower/optimize it?
Hi @EkilRevolution, that's possible-I'm familiar with the body temp reduction for CR, but do you have a list of papers to share?
Amazing video man, thanks as always. I really dislike Brazil nuts, would you recommend any other food that is high in selenium? Failing that, I know you don’t like the supplement route as much, but what would a safe low-medium dose be to top up my intake from whole foods? Appreciate you!
Thanks @bevnae. Mushrooms are also a good source, but you'd have to eat a lot to go beyond the RDA
For people who supplement, I'd recommend full panel blood testing (not just thyroid hormones) to see if the net effect is negative, neutral, or positive.
Many kinds of fish would be a good source
Nothing about TSH? I only have a few data points for FT3 and FT4 as well. Getting those tested is kind of expensive and tricky to order, especially the Reverse T3. So few people measure these. I was hoping to see more on how TSH relates to FT3 and FT4. I've actually been able to go down from 100mcg L-thyroxine to 88mcg, though I have taken 100mcg for over 20 years. Running does seem to impact TSH levels for me. I look forward to more videos on this.
Hi Gail, TSH will probably be in a future video-FT3 and FT4 are more interesting, imo (as a start). I'm only ordering TSH, FT3 and FT4, not rT3 or T2...
@@conqueragingordietrying1797 You've explained more than any of my doctors have ever explained to me! They only seem to care about TSH. I'd also be interested to know if you think you can ever expect to be able to get off meds. I never thought I would, but now it seems I am able to at least reduce dosage. I also started looking at TgAb and TPO.
Have you ever ordered lab analysis of any food item to see whether the content of compounds of interest match the numbers from literature?
Seems somewhat important to know in this case, since there's an upper limit you're already close to. That is if the data is applicable.
Not yet, but that could be coming soon!
growth hormone also falls with age . it is a age clock equvalent. so statistically , those with low growth hormone being of older biological age will have higher mortality. but genetically lower growth hormone give u longer life. I suspect thyroid hormone fall under this category
The frailty data in the video argues against lower free T3 being good for health at older age.
Why not use dessicated thyroid or levothroxine plus t3 . As you take more levothyroxine , you produce more t3 AND rT3. RT3 competitively attaches to receptors and block t3 actions? Selenium may help but doesnt solve the rT3 . Check rT3 too!
I'd prefer to figure out the recipe for my body to fix the conversion issue-taking T3 doesn't address the root cause
Agree with this comment. T4 replacement monotherapy doesn’t mimic natural physiology and will bias toward a higher free T4 / lower free T3
@@conqueragingordietrying1797 you may not be able to address the root cause, which could be part of the underlying hypothyroidism. Wondering if, aside from that, you have some objection to using T3/cytomel?
AC on... feeling the summer?
Ha, yep. Otherwise, I'd be sweating without it while making the video!
I've read research showing that the selenium content of brazil nuts varies hugely, depending on source, growing conditions etc. Sorry I don't have the reference to hand.
So, you could be massively exceeding or undershooting your 400mcg target, even from batch to batch of brazil nuts from the same shop. In this case, you might be better off initially taking a supplement to properly control your selenium intake, at least as a proof of concept.
I have by far the lowest level. According to that, Im 120yo.
Ratio is even more worse: 0.22
Ft4: 17.12pmol/l
Ft3: 4.9pmol/l
Im 44yo. Now Im really shocked.
Ive also had some tests in the past: they were a bit better, but fae away from optimal.
At least one bloodmarker there I am over 20. Haha. -.-
Sorry to hear that, @chris-lk4ml. I'm in the same boat, and am confident that I can improve the ratio, and further resist its age-related decline!
Sir i am watching your videos out of order. I recall your SHBG is very high. There is some correlation between thyroxine replacement and SHBG levels , yes ?
That's news to me, @barrie888. Can you please post some papers showing a correlation between T4 with SHBG?
@@conqueragingordietrying1797 Effect of D thyroxine on serum sex hormone binding globulin, testosterone and pituitary function in euthyroid subjects, journal of endocrinological investigation October 1984 7(5) " 4mg dose D-T4 induced an increase in SBHG levels in all but one man. & "Significant negative correlation between SHBG and percent free T
i bought a 'natural' thyroid supplement in torontos chinatown many years ago for $30 , bottle had 400 small pressed pills
turned out to be dried pork thyroid or something to that effect which had
my ft3, ft4 was through the roof and tsh was
You should supplement with Lugols iodine.
The focus of the video is conversion of FT4 to FT3, which is not an iodine issue. If FT4 was low, that could be possible, but instead, I'd like to improve the conversion of FT4 to FT3, which removes one of the iodine atoms from thyroxine.
Excess Iodine is actively harmful for Hashimoto's hypothyroidism.
Very helpful. Thanks. Couldn’t you just increase Levo thyroid hormone to increase the ratio?
Thanks @Thomas-wz2nu. Ah, the ratio is what's most important-while FT3 could increase, FT4 may stay relatively high in that situation, not changing the ratio.
@@conqueragingordietrying1797sure, in fact I just discovered that Levo may reduce the ratio:
@@conqueragingordietrying1797 pubmed.ncbi.nlm.nih.gov/30396211/
@@conqueragingordietrying1797 understood why selenium important- also apparently Vit D
@@conqueragingordietrying1797 Possible that Levo may be part of the problem: pubmed.ncbi.nlm.nih.gov/30396211/
For the 4/29/24 calculation, shouldn't it be 1.8, not 0.18? Also one is in ng, the other in pg, so there is a factor of 1000 that seems to have disappeared.
Hi @Battery-kf4vu, the goal is for the units to both be in pg/mL, so FT4 needs to be converted to pg/mL. To do that, multiply FT4's ng/dL by 10. Calculator data is below:
unitslab.com/node/121
@@conqueragingordietrying1797 Ha that's right, I hadn't see the dL and the mL. Jesus Christ can't they use the same unit?...
Apart from this I've read in studies saying that a higher TSH is associated with lower mortality. And according to this study for instance:
"Selenium Supplementation in Patients with Hashimoto Thyroiditis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials"
increasing selenium decreases TSH.
conquer ageing- may i ask, so how many brazil nuts per day does that translate to? 2-4? i only eat around 2 brazil nuts per day, there is such a thing as selenium toxicity, most literature/vids say only eat no more than 2 per day. interesting topic, i have to take 150mcgs tirosint liquid levothyroxine, can't convert pill form. please let me know the brazil nut amount. thanks.
Sure @jimjam1719, no worries, it's around 4/day
The tolerable upper limit is 400 mcg/d, but I'm doing full panel blood testing 7x/year to check if I'm making other stuff worse. That's the approach that I would recommend, rather than increasing intake without testing...
@@conqueragingordietrying1797 k. thanks. i might go to 4 at most to see if anything happens.
Hi, Michael i have a question about niacin you took 60 mg to increst nad but how much is your weigh becuse i want to try it too but maybe low dose that 60 mg beacuse i have only some 51 kg i want to try maybe 21.25 mg nikotynamid and 10 mg niacin and i saw when i take 16mg of nikotynamid i got realy good boost of energy i didnt test that but this is how i feel
Hi @Anonymousextb, 141 lbs
@@conqueragingordietrying1797 thanks
In reviewing this video again, I'm trying to understand the ratio: FT3/FT4. If FT3 is 2.9 and FT4 is 0.99, shouldn't FT3 be in the numerator? Even if it's the other way around, wouldn't your first ratio be 0.34 instead of 0.30? My latest thyroid check I got the exact same results as you did on 4/29/24. My Reverse T3 was 21. My doctor said my T3 was suboptimal and that reverse T3 was "high normal." I'm taking 88mcg levothyroxine, but my doctor just now switched me to the brand Synthroid, saying that it helps improve conversion. I'm interested to know if you have tried using the brand. I've never seen anyone calculate this FT3/FT4 ratio, so it's nice to have and additional metric to track. And I look forward to your follow-up on this after your next test. It's unfortunate that these test are relatively expensive, and I have not even found a way to order reverse T3 directly from Quest.
Thanks Gail. Within this context, FT3/FT4 = 2.9/(0.99 *10) = 0.29
I don't remember if I've taken L-thyroxine-I think mine is generic L-thyroxine
I've been using ultalabtests.com, which has rT3
I'm more interested in the FT3/FT4 ratio, less on rT3, for now, though. In your case, it sounds like more free T4 is being converted into rT3 instead of FT3-I'd recommend tracking all 3 at every test, to see what may shift the balance back to FT3...
@@conqueragingordietrying1797 Ah, I see: you have to multiply the FT4 units by 10. Now it makes sense. I plan to measure all my thyroid markers quarterly going forward. I have some historical data, but I was not sure how to impact it (or even what it all meant). My doctor says switching from generic to brand will help with my conversion. I'll let you know the results of this switch in three months!
@@roots2buds Good luck Gail!
Why selenium/brazil nuts and not cytomel/liothyronine to increase the T3 to T4 ratio?
I try to use prescription meds as the last resort-the primary strategy is via diet, as that can address root causes.
I have a high ratio of 0.487 with T3 5.57 pmol/l and T4 11.43 pmol/l. I'm 37 and so it seems my T4 is super low and T3 is super high based on this pictures. My lab tells me my reference range is 3.53 - 6.80 for T3 and 7.70-14.20 for T4.
I'm having trouble to make sense of this data.
Is it free T3 and T4, or total?
@@conqueragingordietrying1797 It's free T3 and free T4. (Sorry, for late reply)
I am surprised you would elevate selenium after you made a video that showed optimal intake to be 150-200 micrograms or something like that, and higher levels in your data appeared to hurt several biomarkers. Well, there is nothing wrong with testing, rather than just trusting the correlations. I wish there were more people out there generating and presenting good data like this.
Thanks @ChessMasterNate, and yep, I'm going beyond what I initially proposed as optimal. I'm hoping to test on Tuesday, assuming that seasonal allergies don't force a test delay.